血浆高迁移率族蛋白B1浓度与脑外伤预后的相关性分析

目的:揭示脑外伤患者血浆高迁移率族蛋白B1(HMGB1)浓度,分析其与预后的相关性.方法:收集重型脑外伤患者118例和同期健康体检正常者50例.健康体检正常者静脉血体检时获得,脑外伤患者静脉血在入院时获得.ELISA测定血浆HMGB1浓度,统计分析其与预后的相关性.结果:t检验显示,脑外伤患者血浆HMGB1浓度(9.4±2.3)ng/ml显著高于健康体检正常者(1.6±0.3)ng/ml(t=9.583,P＜0.01).多因素分析显示,血浆HMGB1浓度是脑外伤1周内死亡(OR=1.309,95％CI=1.197～1.743,P＜0.01)、1年内死亡(OR=1.476,95％CI=1.208～1.796,P＜0.01)和1年内神经功能预后不良(格拉斯哥预后评分1～3分)(OR=1.419,95％CI=1.218～1.697,P＜0.01)的独立危险因素,ROC曲线分析显示,血浆HMGB1浓度可预测脑外伤1周内死亡(曲线下面积=0.865,95％CI=0.824～0.901,P＜0.01)、1年内死亡(曲线下面积=0.891,95％CI=0.835～0.934,P＜0.01)和1年内神经功能预后不良(曲线下面积=0.876,95％CI=0.832～0.925,P＜0.01).结论:脑外伤后血浆HMGB1浓度显著升高,临床检测这些指标有助于早期判断脑外伤预后.

Correlative Analysis of Plasma High Mobility Group Box 1 Protein Concentration with Prognosis of Patients with Traumatic Brain Injury

Objective To observe plasma high mobility group box 1 protein level in the patients with traumatic brain injury and evaluate its correlation with disease outcome.Methods 118 consecutive patients with acute severe traumatic brain injury and 50 ageand sex-matched healthy controls were enrolled into this study simultaneously.Plasma samples were obtained on entry in healthy controls and on admission in the patients.Its concentration was measured by enzyme-linked immunosorbent assay.Results Plasma high mobility group box 1 protein level in the patients(9.4±2.3 ) ng/ml was substantially higher than that of healthy controls(1.6±0.3 ) ng/ml(P <0.01) using T test.A multivariate analyses selected plasma high mobility group box 1 protein level as an independent predictor for 1-week mortality(OR = 1.309,95%CI = 1.197～1.743,P<0.01),1 -year mortality(OR = 1.476,95%CI = 1.208～1.796,P <0.01) and 1-year unfavorable outcome(OR = 1.419,95%CI = 1.218～1.697,P <0.01).A receiver operating characteristic curve analyses showed that plasma high mobility group box 1 protein level predicted 1 -week mortality(Area under curve = 0.865, 95%CI =0.824～0.901,P<0.01),1 -year mortality(Area under curve =0.891,95%CI = 0.835～0.934,P<0.01) and 1-year unfavorable outcome(Area under curve = 0.876,95%CI = 0.832～0.925,P <0.01)obviously.Conclusion Increased plasma high mobility group box 1 protein level was found after traumatic brain injury,in association with a poor clinical outcome.